Some babies born very small do just fine as adults

NEW YORK (Reuters Health) - Although babies who are born
weighing less than 3.3 pounds face challenges early on, by
adulthood many report doing well, according to a new study.

Growing up, those kids have an increased risk of physical
and mental health problems, past studies have shown. They also
tend to do worse in school than their peers and have a harder
time socially.

But by the time they reach adulthood, many seem to have left
those problems behind.

"It looks to us as if, despite many challenges early on and
some functional issues, like myopia (nearsightedness), they do
catch up," Dr. Brian A. Darlow said.

He led the study at the University of Otago, Christchurch in
New Zealand.

Darlow and his coauthors checked in with 230 adults, age 22
or 23, who were born in New Zealand in 1986 at a very low birth
weight - defined as less than 3.3 pounds.

Compared to a group of 69 adults who were born at healthy
weights, the formerly small babies were still about 12 pounds
lighter and 1.7 inches shorter.

They were also slightly less likely to have finished college
or advanced training. More formerly small babies had lived on
welfare at some point and more reported wheezing in the past
year.

Babies born very small are usually premature or have growth
restriction complications, so it makes sense that they would be
prone to breathing issues. Lungs are the last organ system to
fully develop in the womb.

But people in each group rated their self-esteem and
satisfaction with life fairly equally. The formerly small babies
were no more likely to have attention-deficit/hyperactivity
disorder or obsessive compulsive disorder, according to results
published in Pediatrics.

Those participants also scored similarly on measures of
behavioral problems and were no more likely to have had
depression or an anxiety disorder.

People in both groups smoked the same amount of tobacco and
marijuana, on average, and fewer participants from the low birth
weight group had used other illicit drugs.

"For me the most important message is that despite
differences where they existed, these young people rated their
own life functioning and quality of life no different from their
peers," Darlow told Reuters Health. "They think they are doing
okay so we should respect that."

One in ten very low birth weight babies had a moderate or
severe disability of some kind at age seven or eight. That was a
good predictor of which children would still be lagging behind
as adults, he said.

Darlow said he would have liked the study to include more
formerly normal-weight babies for comparison.

"What I personally find perhaps most alarming, and probably
many of my colleagues would agree, is that a larger proportion
of very low birth weight adults report having few or no
friends," which fits with previous studies, Eero Kajantie told
Reuters Health.

Kajantie studies premature birth and long-term health at the
University of Helsinki in Finland.

About half of study participants born at a very low weight
said they had few or no friends, compared to one-third of the
healthy birth weight comparisons.

Only one or two percent of babies are born at a very low
birth weight, but they make up half the population of neonatal
intensive care units, according to the study.

"It is very rewarding to see that despite earlier
difficulties, the majority of premature children have completed
the basic educational requirements," Dr. Saroj Saigal said.

Saigal studies very low birth weight infants as they grow
and age into adulthood at McMaster University in Hamilton,
Ontario, Canada. She was not involved with the New Zealand
study.

A significantly higher proportion of premature babies
require special assistance at school, she said. If this
assistance isn't available it can hamper their development.

But the new findings add to a growing body of evidence that
once these babies reach adulthood, they do well.

"There is light at the end of the tunnel," Saigal told
Reuters Health. "Parents and siblings can be reassured that the
majority of very low birth weight young adults will be able to
live independently."

"Realistic expectations and encouragement, family support
and availability of resources at school can be helpful," she
said.